Cost Versus Effectiveness in HIV Treatment
Until last year, all antiretroviral drugs for HIV treatment were brand named. Generic substitutes are poised to save the United Sates health market about a billion dollars annually, but there’s a different price. The question has arisen as to whether or not these less expensive alternatives will be as effective in warding off the advance of HIV – a study in Massachusetts was conducted to address this very issue.
Basically the question becomes: How much is life worth? We are talking about both the length of a person’s life, and their ability to enjoy it to the full. The generic drugs may not be able to extend the life of an HIV patient quite as long or give all of the same health benefits, so is an astronomical saving, even $1 billion, worth it?
In 2011, HIV medicines cost the US about $9 billion. Most of this was paid for by the government. Now the issue faced by doctors is to determine what to prescribe, the patients who they can afford to treat, and the implications in wider society since most of the meds are being paid for by tax dollars.
Right now, HIV patients need to take a combination of three brand named drugs on a daily basis. Last year already saw a generic version appear on the market for one of these medications – 2013 will add another.
What effects will this have on patients? For one thing, the generic meds need to be taken three times per day instead of once – this makes the daily regimen more complicated and could result in more patients forgetting to take a vital dose. Missing doses can result in the treatment failing and the disease progressing. Furthermore, the use of the generic medicine currently on the market has proven to be slightly less effective in studies.
Using a mathematical model and examining worst case scenario predictions, it appears that while individual patients could save over $42,000 dollars in treatments, they could also lose an average of four and half months off their life span. Would you pay $42,000 for four and a half months longer to live? I think that anyone would take that offer if they could.